[Factors associated with high-risk drinking among men in Korea: a secondary analysis].

The incidence of end-stage renal disease (ESRD) has continued to increase. In 2022, 134,826 people were reported to have ESRD in South Korea, and the proportion of patients undergoing hemodialysis is increasing every year []. ESRD is a disease in which kidney function is impaired owing to a range of etiologies, including chronic glomerulonephritis, and the glomerular filtration rate is irreversibly reduced. Renal replacement therapy is necessary when the filtration rate decreases to 10% of the patients normal range []. Among ESRD patients, the proportion of those receiving hemodialysis is high (83.6 %). These patients are required to visit the hospital 2-3 times a week for 3-4 hours of dialysis during each visit []. Despite receiving continuous dialysis treatment, patients experience physical and emotional symptoms, such as fatigue, lack of energy, dry skin, itching, sleep disorders, and anxiety owing to insufficient excretion of water, salt, and waste products []. The hospitalization rate in Korea is increasing owing to the comorbidities of dialysis patients and the side effects of treatment, rising from 76.2% per 1,000 people in 2013 to 292.3% by 2022 []. In addition, the mortality rate of dialysis patients is increasing; rubbing shoulders with the rates of cardiovascular diseases and infections []. Patients with chronic illnesses, including hemodialysis patients, show low adherence to self-care behaviors, such as engaging in regular physical activity, taking prescribed medications, and maintaining a proper diet []. Therefore, self-care is vital for disease management because it helps reduce chronic physical and mental disease complications []. In general, people with chronic diseases need to actively and effectively perform self-care to manage their illness []; hemodialysis patients need to engage in self-care to maintain their life, health, and well-being. It is a personal endeavor and practical act that an individual needs to take to reduce disease progression, prevent complications, and maintain overall health []. One may think that their disease is managed with hemodialysis alone, and although the treatment relieves symptoms of uremia and reduces the risk of organ failure, it only assumes the excretory function of the kidneys. Therefore, other self-care measures are important to prevent side effects and complications []. It is especially important for hemodialysis patients to pay attention to their health and proactively engage in self-care to manage their illness and achieve an optimal quality of life []. In this regard, self-care for hemodialysis patients refers to what patients do to maintain their health. These include managing arteriovenous fistulas, taking medications, following dialysis schedules, and managing diets and fluids []. Previous studies have shown that self-care in hemodialysis patients is significantly correlated with knowledge and self-efficacy [], and that knowledge of hemodialysis and self-care behaviorare positively correlated []. Topics related to hemodialysis include kidney function, blood vessel management, medication management, dialysis, exercise, and daily routines []. Improving treatment knowledge is important to ensure effective disease management []. Prior research has shown that self-care behavior improves in hemodialysis patients when they acquire accurate knowledge about dialysis and disease managementand build self-efficacy []. A study on older hemodialysis patients found that increased self-efficacy encourages them to stay on life support and prevents further deterioration in their health []. Other studies have reported that higher self-efficacy is associated with better performance of self-care behaviors [].